Association Between Systemic Arterial Stiffness and Choroidal Vascular Resistance Assessed by Laser Speckle...

This study aimed to investigate the association between peripapillary choroidal hemodynamics, as measured by laser speckle flowgraphy (LSFG), and systemic arterial stiffness, indicated by the cardio-ankle vascular index (CAVI), in patients with diabetic retinopathy (DR).

In this retrospective cross-sectional study, 72 eyes from 72 patients with type 2 diabetes across DR stages were analyzed. Choroidal parameters, including mean blur rate (MBR; indicating blood flow), beat strength (BS; reflecting pulsatility), and the BS/MBR ratio (BOM; a resistance-related waveform index), were quantified in both temporal and nasal peripapillary regions. A stepwise multiple regression analysis was conducted to identify independent predictors of CAVI, considering age, sex, and LSFG parameters.

In univariate analyses, higher CAVI was significantly associated with increased choroidal pulsatility and resistance (P < 0.05). In the final exploratory stepwise multivariable model, age remained significantly associated with higher CAVI (β = 0.048, P = 0.020), while temporal BOM showed a borderline positive trend with CAVI (β = 2.719, P = 0.055). The model was statistically significant overall (adjusted R² = 0.326, P < 0.001).

In patients with DR, age was the most robust determinant of CAVI. The retention of regional choroidal BOM parameters in the final exploratory stepwise model suggests a possible association whereby systemic pulsatile stress may influence choroidal hemodynamics, although these findings are exploratory and hypothesis-generating.

LSFG-derived choroidal resistance (BOM) may help explore the ocular-systemic vascular connection in diabetes management.